NOViSE: a virtual natural orifice transluminal endoscopic surgery simulator

Purpose: Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a novel technique in minimally invasive surgery whereby a flexible endoscope is inserted via a natural orifice to gain access to the abdominal cavity, leaving no external scars. This innovative use of flexible endoscopy creates many new challenges and is associated with a steep learning curve for clinicians. Methods: We developed NOViSE - the first force-feedback enabled virtual reality simulator for NOTES training supporting a flexible endoscope. The haptic device is custom built and the behaviour of the virtual flexible endoscope is based on an established theoretical framework – the Cosserat Theory of Elastic Rods. Results: We present the application of NOViSE to the simulation of a hybrid trans-gastric cholecystectomy procedure. Preliminary results of face, content and construct validation have previously shown that NOViSE delivers the required level of realism for training of endoscopic manipulation skills specific to NOTES Conclusions: VR simulation of NOTES procedures can contribute to surgical training and improve the educational experience without putting patients at risk, raising ethical issues or requiring expensive animal or cadaver facilities. In the context of an experimental technique, NOViSE could potentially facilitate NOTES development and contribute to its wider use by keeping practitioners up to date with this novel surgical technique. NOViSE is a first prototype and the initial results indicate that it provides promising foundations for further development

Art and Medicine: A Collaborative Project Between Virginia Commonwealth University in Qatar and Weill Cornell Medicine in Qatar

Four faculty researchers, two from Virginia Commonwealth University in Qatar, and two from Weill Cornell Medicine in Qatar developed a one semester workshop-based course in Qatar exploring the connections between art and medicine in a contemporary context. Students (6 art / 6 medicine) were enrolled in the course. The course included presentations by clinicians, medical engineers, artists, computing engineers, an art historian, a graphic designer, a painter, and other experts from the fields of art, design, and medicine. To measure the student experience of interdisciplinarity, the faculty researchers employed a mixed methods approach involving psychometric tests and observational ethnography. Data instruments included pre- and post-course semi-structured audio interviews, pre-test / post-test psychometric instruments (Budner Scale and Torrance Tests of Creativity), observational field notes, self-reflective blogging, and videography. This book describes the course and the experience of the students. It also contains images of the interdisciplinary work they created for a culminating class exhibition. Finally, the book provides insight on how different fields in a Middle Eastern context can share critical /analytical thinking tools to refine their own professional practices

Home-based therapy programmes for upper limb functional recovery following stroke

Background: With an increased focus on home-based stroke services and the undertaking of programmes, targeted at upper limb recovery within clinical practice, a systematic review of home-based therapy programmes for individuals with upper limb impairment following stroke was required. Objectives: To determine the effects of home-based therapy programmes for upper limb recovery in patients with upper limb impairment following stroke. Search methods: We searched the Cochrane Stroke Group's Specialised Trials Register (May 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2), MEDLINE (1950 to May 2011), EMBASE (1980 to May 2011), AMED (1985 to May 2011) and six additional databases. We also searched reference lists and trials registers. Selection criteria: Randomised controlled trials (RCTs) in adults after stroke, where the intervention was a home-based therapy programme targeted at the upper limb, compared with placebo, or no intervention or usual care. Primary outcomes were performance in activities of daily living (ADL) and functional movement of the upper limb. Secondary outcomes were performance in extended ADL and motor impairment of the arm. Data collection and analysis: Two review authors independently screened abstracts, extracted data and appraised trials. We undertook assessment of risk of bias in terms of method of randomisation and allocation concealment (selection bias), blinding of outcome assessment (detection bias), whether all the randomised patients were accounted for in the analysis (attrition bias) and the presence of selective outcome reporting. Main results: We included four studies with 166 participants. No studies compared the effects of home-based upper limb therapy programmes with placebo or no intervention. Three studies compared the effects of home-based upper limb therapy programmes with usual care. Primary outcomes: we found no statistically significant result for performance of ADL (mean difference (MD) 2.85; 95% confidence interval (CI) -1.43 to 7.14) or functional movement of the upper limb (MD 2.25; 95% CI -0.24 to 4.73)). Secondary outcomes: no statistically significant results for extended ADL (MD 0.83; 95% CI -0.51 to 2.17)) or upper limb motor impairment (MD 1.46; 95% CI -0.58 to 3.51). One study compared the effects of a home-based upper limb programme with the same upper limb programme based in hospital, measuring upper limb motor impairment only; we found no statistically significant difference between groups (MD 0.60; 95% CI -8.94 to 10.14). Authors' conclusions: There is insufficient good quality evidence to make recommendations about the relative effect of home-based therapy programmes compared with placebo, no intervention or usual care

Community space in complex learning communities : lessons learnt

Highly complex learning communities where diverse participants collaborate to achieve multiple aims through synergy have the potential to be highly creative and productive. However the diversity and multiple aims can also mean the advantages of a community - share understand, trust and direction - are difficult to achieve, resulting in few if any of the aims being realised. We review two case studies, where the learning community is trying to achieve multiple aims, in order to explore how virtual and physical space are employed to support collaborative learning and enhance synergistic potential. The analysis shows that high levels of diversity have influenced these spaces and trends towards differentiation and holistically designed hybrid, virtual and physical, collaboration space. The characteristics of theses cases are sufficiently general to lead us to draw insights for the building of collaborative space in multi-purpose complex learning communities. These are equably applicable to learning communities which share features such as heterogeneity, multiple locations or a mixture of spaces

Effects Of Human Cadaveric Dissections In High School Biology

This study was conducted in a suburban public high school, which had a connection to the local university, to measure the achievement of dual enrollment senior students using traditional hands-on (THO) cadaveric dissections compared to non-traditional (NT) virtual dissections of the human body. The outcomes of this study may assist multicultural science educators and administrators, students and parents, to understand the importance of THO cadaveric dissections compared to NT virtual dissections tools in learning gross anatomy. Also, noted is the importance of public and higher education collaboration to help bridge the science resource gaps between educational settings